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Active Muscle & Inactive Muscle

Differential Diagnosing of
Inflammatory Myopathies
In medicine, a differential diagnosis is a diagnosis which examines all of the possible causes for a set of
symptoms in order to arrive at a diagnosis. When considering the differences that involve Inflammatory
Myopathies, there are a number of factors to consider. The list below gives a few examples.
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     Weakness Alone
    • Endocrine Myopathies
      • Thyroid Disease (Hyper & Hypo) - Thyroid disorder Endocrinology Any benign or malignant condition that affects the structure or function of the thyroid gland. Hyperthyroidism is the overproduction of thyroid hormones by an overactive thyroid. Hypothyroidism, or underactive thyroid, develops when the thyroid gland fails to produce or secrete as much thyroxine (T4) as the body needs. Because T4 regulates such essential functions as heart rate, digestion, physical growth, and mental development, an insufficient supply of this hormone can slow life-sustaining processes, damage organs and tissues in every part of the body, and lead to life-threatening complications.
      • Cushing Syndrome - A disorder resulting from increased adrenocortical secretion of cortisol due to any one of several sources: adrenocorticotropic (ACTH)-dependent adrenocortical hyperplasia or tumor, ectopic ACTH-secreting tumor, or excessive administration of steroids; characterized by truncal obesity, moon face, acne, abdominal striae, hypertension, decreased carbohydrate tolerance, protein catabolism, psychiatric disturbances, and osteoporosis, amenorrhea, and hirsutism in females; when associated with an ACTH-producing adenoma, called Cushing disease. 
    • Drug-related Myopathies
      • Statins - blood lipid-regulating drugs, e.g. atorvastatin, simvastatin, indicated as prophylactic therapy in patients with coronary or peripheral vascular disease, and in diabetic and hypertensive patients; 40mg daily reduces atherosclerotic plaque formation.
      • Steroids - A group of drugs that includes the corticosteroids, similar to hormones produced by the adrenal glands, and used to relieve inflammation and itching.
      • Diuretics - substances contained in food and drink (e.g. caffeine), or given as medication, that increase the secretion of urine by the kidneys (diuresis). Used in medicine as a treatment for high blood pressure. Powerful drugs, often termed 'water tablets', that control hypertension and peripheral oedema; action of some local anaesthetics is antagonized by concomitant use of some diuretics.
      • Colchicine - A compound that blocks the assembly of microtubules-protein fibers necessary for cell division and some kinds of cell movements, including neutrophil migration. Side effects may include diarrhea, abdominal bloating, and gas.
      • Hydroxychloroquine - (Plaquenil) an anti inflammatory and antiprotozoal used as the sulfate salt in the treatment of malaria, lupus erythematosus, and rheumatoid arthritis. Disease-modifying antirheumatic drug (DMARD) used to treat active rheumatoid disease; better tolerated than gold or penicillamine; may cause retinopathy and exacerbate psoriasis and myasthenia gravis.
    • Amyloidosis - Amyloidosis is a progressive, incurable, metabolic disease characterized by abnormal deposits of protein in one or more organs or body systems.
    • Sarcoidosis - Sarcoidosis is a disease which can affect many organs within the body. It causes the development of granulomas. Granulomas are masses resembling little tumors. They are made up of clumps of cells from the immune system.
    • Neuropathies - A condition affecting the nerves supplying the arms and legs. Typically, the feet and hands are involved first. If sensory nerves are involved, numbness, tingling, and pain are prominent, and if motor nerves are involved, the patient experiences weakness.
    • Polymyalgia Rheumatica - Although the major characteristics of this condition are just pain and stiffness, there are reasons to believe it is more than just old-fashioned rheumatism. Patients are commonly so afflicted that their muscles atrophy from disuse. A similar complaint of such weakness is also seen in serious muscle diseases. Moreover, some patients develop arthritis or a disease called giant cell arteritis or temporal arteritis.
    • Metabolic Myopathies - muscular dystrophies caused by metabolic defects; include systemic glycogenoses, deposits of a PAS-positive glycoprotein, the lipid storage disease of cats caused by carnitine deficiency.
    • Lipid Storage Disorders - (lipidoses) are a group of inherited metabolic disorders in which harmful amounts of lipids (fats) accumulate in some of the body’s cells and tissues. People with these disorders either do not produce enough of one of the enzymes needed to metabolize lipids or they produce enzymes that do not work properly. Over time, this excessive storage of fats can cause permanent cellular and tissue damage, particularly in the brain, peripheral nervous system, liver, spleen and bone marrow.
    • Mitochondrial Diseases - is a group of disorders caused by dysfunctional mitochondria, the organelles that generate energy for the cell. Mitochondria are found in every cell of the human body except red blood cells. Mitochondria convert the energy of food molecules into the ATP that powers most cell functions.
  • Neuromuscular Transmission Disorders
    • Myasthenia Gravis - (from Greek μύς "muscle", ἀσθένεια "weakness", and Latin: gravis "serious"; abbreviated MG) is an autoimmune neuromuscular disease leading to fluctuating muscle weakness and fatigability. It is an autoimmune disorder, in which weakness is caused by circulating antibodies that block acetylcholine receptors at the post synaptic neuromuscular junction, inhibiting the excitatory effects of the neurotransmitter acetylcholine on nicotinic receptors throughout neuromuscular junctions.
  • Paraneoplastic Syndromes
    • Eaton-Lambert Syndrome - is a rare autoimmune disorder that is characterized by muscle weakness of the limbs. It is the result of an autoimmune reaction in which antibodies are formed against presynaptic voltage-gated calcium channels, and likely other nerve terminal proteins, in the neuromuscular junction (the connection between nerves and the muscle that they supply). Around 60% of those with LEMS have an underlying malignancy, most commonly small cell lung cancer; it is therefore regarded as a paraneoplastic syndrome (a condition that arises as a result of cancer elsewhere in the body).
  • Muscular Dystrophies
    • Limb-Girdle Dystrophy - Limb-girdle muscular dystrophy is a term for a group of diseases that cause weakness and wasting of the muscles in the arms and legs. The muscles most affected are those closest to the body (proximal muscles), specifically the muscles of the shoulders, upper arms, pelvic area, and thighs.
    • Facioscapulohumeral Dystrophy - also known as Landouzy-Dejerine, is a usually autosomal dominant inherited form of muscular dystrophy (MD) that initially affects the skeletal muscles of the face (facio), scapula (scapulo) and upper arms (humeral). While it is widely stated to be the third most common genetic disease of skeletal muscle, a 2008 analysis of rare diseases listed FSHD as the most prevalent form of MD at 7/100,000.
    • Duchenne Muscular Dystrophy - (DMD) is a recessive X-linked form of muscular dystrophy, affecting around 1 in 3,600 boys, which results in muscle degeneration and eventual death. The disorder is caused by a mutation in the dystrophin gene, the largest gene located on the human X chromosome, which codes for the protein dystrophin, an important structural component within muscle tissue that provides structural stability to the dystroglycan complex (DGC) of the cell membrane. While both sexes can carry the mutation, females rarely exhibit signs of the disease.
  • Motor Neuron Disorders
    • Spinal Muscular Atrophy - (SMA) is an autosomal recessive disease caused by a genetic defect in the SMN1 gene that codes SMN, a protein widely expressed in all eukaryotic cells. SMN1 is apparently selectively necessary for survival of motor neurons, as diminished abundance of the protein results in death of neuronal cells in the anterior horn of the spinal cord and subsequent system-wide muscle wasting (atrophy).
    • Amyotrophic Lateral Sclerosis – Lou Gehrig Disease - (ALS) – also referred to as Motor Neuron Disease in some Commonwealth of Nations countries and as Lou Gehrig's Disease in the United States – is a debilitating disease with varied etiology characterized by rapidly progressive weakness,muscle atrophy and fasciculations, muscle spasticity, difficulty speaking (dysarthria), difficulty swallowing (dysphagia), and difficulty breathing (dyspnea). ALS is the most common of the five motor neuron diseases.
  • Vasculitis / Polyarteritis Nodosa
  • Vasculitis - refers to a varied group of disorders which all share a common underlying problem of inflammation of a blood vessel or blood vessels. The inflammation may affect any size blood vessel, anywhere in the body. It may affect either arteries and/or veins. The inflammation may be focal, meaning that it affects a single location within a vessel; or it may be widespread, with areas of inflammation scattered throughout a particular organ or tissue, or even affecting more than one organ system in the body.
  • Polyarteritis Nodosa - a severe and poorly understood collagen vascular disease in which widespread inflammation and necrosis of small and medium-sized arteries and ischemia of the tissues they serve occur. Any organ or organ system may be affected. The disease attacks men and women between 20 and 50 years of age. Its cause is unknown, although immunologic factors are suspected. Polyarteritis nodosa may be acute and rapidly fatal or chronic and wasting. 
  • Spinal Stenosis
  • Spinal Stenosis - An abnormal narrowing (stenosis) of the spinal canal that may occur in any of the regions of the spine. This narrowing causes a restriction to the spinal canal, resulting in a neurological deficit. Symptoms include pain, numbness, paraesthesia, and loss of motor control. The location of the stenosis determines which area of the body is affected. With spinal stenosis, the spinal canal is narrowed at the vertebral canal, which is a opening between the vertebrae where the spinal cord (in the cervical or thoracic spine) or nerve roots (in the lumbar spine) pass through. There are several types of spinal stenosis: Cervical Spinal Stenosis - The most common forms are cervical spinal stenosis, at the level of the neck, and lumbar spinal stenosis, at the level of the lower back. Thoracic Spinal Stenosis - Thoracic spinal stenosis, at the level of the mid-back, is much less common. Lumbar Stenosis - the spinal nerve roots in the lower back are compressed which can lead to symptoms of sciatica, (tingling, weakness, or numbness that radiates from the low back and into the buttocks and legs).
     Weakness (with or without rash)
    • Viral
      • Enterovirus (eg, polio) - often called polio or infantile paralysis, is an acute, viral,infectious disease spread from person to person, primarily via the fecal-oral route. The term derives from the Greek poliós (πολιός), meaning "grey", myelós (µυελός“marrow”), referring to the grey matter of the spinal cord, and the suffix -itis, which denotes inflammation., i.e., inflammation of the spinal cord’s grey matter, although a severe infection can extend into the brainstem and even higher structures, resulting in polio encephalitis, producing apnea that requires mechanical assistance such as an iron lung.
      • Influenza - commonly known as "the flu", is an infectious disease of birds and mammals caused by RNA viruses of the family Orthomyxoviridae, the influenza viruses. The most common symptoms are chills,fever, runny nose, sore throat,muscle pains, headache (often severe), coughing, weakness/fatigue and general discomfort.
      • Parvovirus B19 - or sometimes erythrovirus B19, was the first (and until 2005 the only) known human virus in the family of parvoviruses, genus erythrovirus. B19 virus causes a childhood rash called fifth disease or erythema infectiosum which is commonly called slapped cheek syndrome. The virus was discovered by chance in 1975 by Australian virologist Yvonne Cossart. It gained its name because it was discovered in well B19 of a large series of microtiter plates labelled in this way.
      • Human T-lymphotropic Virus Type 1 - A retrovirus associated with a rare form of T-cell leukemia occurring primarily in the Caribbean area, Africa, and Japan. Also known as human T-cell lymphotropic virus type.
      • Hepatitis B virus – HBV - Hepatitis B is a potentially serious form of liver inflammation due to infection by the hepatitis B virus (HBV). It occurs in both rapidly developing (acute) and long-lasting (chronic) forms, and is one of the most common chronic infectious diseases worldwide. An effective vaccine is available that will prevent the disease in those who are later exposed.
    • Bacterial / Parasitic
      • Toxoplasmosis - Toxoplasmosis is an infectious disease caused by the one-celled protozoan parasite Toxoplasma gondii. Although most individuals do not experience any symptoms, the disease can be very serious, and even fatal, in individuals with weakened immune systems.
      • Trichinella Spiralis (trichinosis) - Parasitology A globally distributed nematode that causes trichinosis, which is found in carnivore and omnivore muscle after ingestion of larvae in undercooked meat–especially bear and pig meats Morphology 1.5 mm, thinner in the front; the anus is subterminal.
      • Borrelia burgdorferi – Lyme disease - Lyme disease is an infection transmitted by the bite of ticks carrying the spiral-shaped bacterium Borrelia burgdorferi. The disease was named for Lyme, Connecticut, the town where it was first diagnosed in 1975 after a puzzling outbreak of arthritis. The organism was named for its discoverer, Willy Burgdorfer. The effects of this disease can be long-term and disabling unless it is recognized and treated properly with antibiotics.
    • Other Connective Tissue Diseases
      • Systemic Lupus Erythematosus - Systemic lupus erythematosus (also called lupus or SLE) is a disease where a person's immune system attacks and injures the body's own organs and tissues. Almost every system of the body can be affected by SLE.
      • Systemic Sclerosis – Scleroderma - Scleroderma is a progressive disease that affects the skin and connective tissue (including cartilage, bone, fat, and the tissue that supports the nerves and blood vessels throughout the body). There are two major forms of the disorder. The type known as localized scleroderma mainly affects the skin. Systemic scleroderma, which is also called systemic sclerosis, affects the smaller blood vessels and internal organs of the body.
      • Mixed Connective Tissue Disease - a combination of scleroderma, myositis, systemic lupus erythematosus, and rheumatoid arthritis, and marked serologically by the presence of antibody against extractable nuclear antigen.
    • Other Inflammatory Disease
      • Inflammatory Bowel Disease - any idiopathic inflammatory disease of the bowel, such as Crohn's disease and ulcerative colitis. 
      • Celiac Disease - a malabsorption syndrome precipitated by ingestion of gluten-containing foods, with loss of villous structure of the proximal intestinal mucosa, bulky, frothy diarrhea, abdominal distention, flatulence, weight loss, and vitamin and electrolyte depletion.
  • Rash Without Weakness
    • Psoriasis An immune-mediated disease that affects the skin. It is typically a lifelong condition. There is currently no cure, but various treatments can help to control the symptoms.

      Psoriasis occurs when the immune system mistakes a normal skin cell for a pathogen, and sends out faulty signals that cause overproduction of new skin cells. It is not contagious. Psoriasis has been linked to an increased risk of stroke, and treating high blood lipid levels may lead to improvement. There are five types of psoriasis: plaque, guttate, inverse, pustular, and erythrodermic. The most common form, plaque psoriasis, is commonly seen as red and white hues of scaly patches appearing on the top first layer of the epidermis (skin). Some patients, though, have no dermatological signs or symptoms. The name psoriasis (ψωρίασις) is from the Greek language, meaning roughly "itching condition" (psora"itch" + -sis "action, condition").

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Psoriasis
  •  Eczema   The term eczema is broadly applied to a range of persistent skin conditions. These include dryness and recurring skin rashes that are characterized by one or more of these symptoms: redness, skin edema(swelling), itching and dryness, crusting, flaking, blistering, cracking, oozing, or bleeding. Areas of temporary skin discoloration may appear and are sometimes due to healed injuries. Scratching open a healing lesion may result in scarring and may enlarge the rash. The word eczema comes from Greek, meaning "to boil over". Dermatitis comes from the Greek word for skin – and both terms refer to the same skin condition. In some languages, dermatitis and eczema are synonymous, while in other languages dermatitis implies an acute condition and "eczema" a chronic one. The two conditions are often classified together.
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Eczema

Click The Links Below To Access Topics On
Autoimmune Diseases

Inflammatory
Myopathies

Body Parts Affected By
Autoimmune Disease

Signs & Symptoms of
Autoimmune Disease

Chronic Inflammation

Pain & Inflammation
Body Parts Affected By Autoimmune Disease    /   Signs & Symptoms of Autoimmune Disease    /   Chronic Inflammation   /   Pain & Inflammation

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